PREVENTION AND TREATMENT OF LOW BACK PAIN: EVIDENCE, CHALLENGES, AND PROMISING DIRECTIONS

Review written by Dr Mary O'Keeffe info

BACKGROUND & OBJECTIVE

Low back pain is a major global challenge, and back-related disability and population burden have increased. Treatment varies widely around the world, from bed rest (mainly in low-income and middle-income countries), to surgery and the inappropriate use of opioids (usually in high-income countries). The Lancet recently published a series consisting of three papers on low back pain, to address the issues around the condition and call for worldwide recognition of low back pain-related disability, and the importance of removing ineffective and harmful practices. The objective of this second paper in the Lancet low back pain series was to outline the recommendations for the treatment and prevention of low back pain.

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METHODS

Relevant publications were identified using broad search terms in PubMed and Scopus and authors based their examples on systematic searches of the published literature. To identify examples from low-income and middle-income countries, authors additionally drew on experts in the Lancet low back pain series team either based, or doing research, in these countries. The authors state that the strength of evidence for the examples of the different solutions to the prevention and management of low back pain varied widely, and therefore they chose to incorporate summaries of the extent of evidence and recommendations to strengthen the evidence base to inform future international efforts.

RESULTS

There is a scarcity of literature on the prevention of low back pain. Popular approaches promoted to prevent low back pain (e.g. work-place education, no-lift policies, ergonomic furniture, mattresses, back belts, lifting devices) lack an evidence base. The only known

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